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Innovation in Integrated &

Person-centred Facilities
The Woodlands Health Campus Experience

Disclaimer: The views expressed in this paper/presentation are the views of the author
and do no necessarily reflect the views or policies of the Asian Development Bank
(ADB), or its Board of Governors, or the governments they represent. ADB does not
guarantee the accuracy of the data included in this paper/presentation and accepts no
responsibility for any consequence of their use. Terminology used may not necessarily
be consistent with ADB official terms.
Introduction
Challenges in the Healthcare Facility Planning
WHC Vision of Transforming Care
Person-centred Medical Planning
Background

By 2030
1 million
Resident population • 1 in 5 will be 65 or older
Urban Master Plan • 1 in 20 with moderate to
server disabilities
• > 30% will live alone

100,000 350,000 1,400


Housing Industrial/ Improved Emergency Visits Outpatient visits Hospital beds
• Close to 30,000 Commercial connectivity
new residential • New Thomson-
• New retail and mixed
dwellings by 2018, East Coast line
use cluster @
adding a total and North South
Woodlands Regional
population of Expressway
Central
135,000 • Industrial developments • 3 MRT stations in
• More units for along Gambas Avenue Woodlands by
multi-generational Surgery and Day Clinical Support
400
and North Coast Wafer 2019
Procedure Facilities Long-term care
living
Fab Park beds
Current Challenges The labour crunch is real and we need to
find ways to operate with lesser manpower

• Ageing population • Labour crunch


• Changing patterns of illnesses • Rapid ageing
• Changing social fabric

• Pandemics

Singapore Population White Paper 2014


http://population.sg/whitepaper/resource-files/population-white-paper.pdf
Current Challenges

Government Health Expenditure


Singapore
The Community We Serve

Woodlands life Changing times Great Expectations Healthy Community


The pros and cons about Woodlands is community in Wishes and hopes around The community healthcare
living in the North transition the new campus needs and struggles
KAMPONG SPIRIT
A strong community spirit,
love/respect for nature,
and keen sense of
belonging

Helpful neighbours are not hard to


come by in Woodlands. Their mutual
respect for other individuals, the
environments, and preference for
calmer surroundings are common
amongst the residents.

Chemistry 2015 8 Chemistry 2015


GREEN OUTDOORS
Spending time outdoors,
in nature - for sports etc
Due to their proximity to Mandai and
the available public green spaces, create
all the more reason for outdoor hobbies
- kite flying and keeping pet birds are
among the many things that people do
in the area.

Chemistry 2015
USED TO CHANGE COPING WITH CHANGING TIMES SENSE OF LOSS
Living in Woodlands, you Change is common, but Losing their peaceful
are used to the idea that the ongoing disruption kampong, replaced by the
the area is constantly is still not welcomed. bustling traffic of people
upgrading
In addition to the construction noise, Residents have claimed ownership to
There have been a lot of new their quiet lives in Woodlands. Although
some people are still superstitious
developments around the area lately, and an upgrade of facilities in Woodlands is
about living near a hospital.
a facility such as the new healthcare well received, residents also voiced their
campus should be in principle well worries over the area turning into a
However, with the rapidly modernising
received by the residents. bustling hub with busy traffic and
population in Singapore, such beliefs
Several voiced optimism about WIHC as a overcrowding. There is a sense of
are slowly being phased out.
potential employer and job creator for the potential loss for their quiet green
residents here. spaces.

Chemistry 2015
HEALTHY INFRASTRUCTURE

Not enough of it, OR


not accessible enough?
Known for their wide varieties and
availability of parks and exercise
corners, Woodlands provides good
means for people to exercise. However,
there is a unanimous call for
more/more accessible polyclinic and
hospital.

ATTACHMENT

We have our own_______


(ie. family doctor, specialist).
Hence, we always visit the
same hospital/clinic.
Choice of hospital/institution to go to is
dependent on where their doctor is.
Patients stick with their doctors
because they have built a trust
relationship with their doctor.
For some, the distance does not matter.

New hospital takes time to build this


emotional connection to flourish.
Woodlands Polyclinic and Yishun Polyclinic are the only 2 serving the North region
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RECEIVING TIMELY CARE

Healthcare is more
time-sensitive than
price-sensitive
• For the needy, price is always a priority. This resulted
in them going a longer route of Polyclinic>Hospital to DECENTRALIZED HEALTHCARE
get their first diagnosis. For those with acute
illnesses, help might've arrived too late.
Demand for a healthcare
practitioner in every social
• Community nurses are unable to refer patients to
service organisation
hospital for subsidised rates. Patients have to be
Charity homes and organisations
referred to Polyclinic first.
(ie. SunLove, Cluster Support, etc) are
ran by volunteers and social workers
with no medical background. Their work
HOLISTIC HEALTHCARE
as care-giver to many elderlies requires
them to know some basic healthcare in Mind, Body and Soul
order to advice as they go door-to-door. Seen as the area with second highest
Currently, this is a learn-as-you-go mental-illness cases after Hougang,
process. there is a higher demand for a holistic
healthcare.

Mentally-ill patients wants to be treated


differently from physical health
patients. Listening ears and caring
hands before referring them to
specialist who are quick to prescribe
them medication.

Chemistry 2015 12 Chemistry 2015


COMMUNITY HEALTHCARE
Support, nurture, involve
and enrich the local
community
The new campus should offer more then
just healthcare. It should be a space
catering to the community needs, be
accessible and welcoming. Not too fancy
or lofty, but affordable and down to
earth. A place within the community, for
the community.

Chemistry 2015 13 Chemistry 2015


Redesigning Care both In- and Out- Campus
Acute Care – Remodel Community Ambulatory Care – Embed Long Term Care -
• Integrate In-Campus and Out-Campus Care emergency and urgent care to allow
stratification to appropriate levels of
Hospital/Rehab Care - health promotion, patient activation,
and community outreach
Redesign long term and End-of-Life
care to promote patient dignity and
Improving functional restoration and
care autonomy.
community transitions

• Clinical Villages for stratified care delivery


Strategic
• Clinical Service Lines to enable care delivery decentralization for early
patient activation and to
across care continuum support good outcome

• Campus as part of the community to inspire


positive and healthy lifestyle

• Campus as a community asset and take Vertical stacking of


advantage of the Park and park connector D&T for expedience
and to support fast-
in fast-out

Designed to take full Located at Northern


advantage of the Park part of Campus for
Home and green space easy access

In-
Community campus
Primary
Care
Out-
Medical
campus
Centre
Focusing on enhancing existing
resources in the community and
building a network of care
14
Person-Centred Medical Planning
Integrated LTC Ambulatory Care Vertical Connection Surgery and
facility Hub between key clinical Critical Care
promotes to activate, enable and function in Podium (e.g.
homelike empower outpatient
Platform
ED, DDR, Surgery) and
care delivery. with OT, SICU and
environment Inpatient Ward Towers
MICU
above

Inpatient Wards
LTC SOC

Arriva
l from
L1, Endo Inpatient Wards Surgery Platform ICU
B1,
B2M,
OP Rehab DDR Cardiology and CCU
B3
and
B4
OP Pharmacy ED

Integrated Logistics Platform

Integrated Logistics Platform to provide efficient support to


Inpatient Ward Towers and key clinical functions. 15
Person-centred Masterplan
The Nature of Healing
Communal Effect
Person-centred Masterplan
• Park Integration
• Block Orientation
• Central Spine
• Acoustic Strategy

The Nature of Healing


Communal Effect
Person-Centred Masterplan

Woodlands Regional Centre

Mandai

Central Water Catchment


Person-Centred Masterplan

BEFORE AFTER

• Reconfiguration of site boundaries


• Symbiotic benefits for both development LTC SOC
Inpatient Wards

• Sharing of infrastructural provisions


Arriva
l from
L1, Endo Inpatient Wards Surgery Platform ICU
B1,
B2M,
OP Rehab DDR Cardiology and CCU
B3
and


B4

Encourages usage of park connector network


OP Pharmacy ED

Integrated Logistics Platform

• A ‘larger park’ for all – everyone wins!


From medical planning to master planning
Person-Centred Masterplan

Learning from the rainforest


• Creating a park-like ground plane
• Conducive for pedestrians of all profiles
• Extensive cycling tracks and parking
• Fenceless, seamless, car-less

FOREST
FLOOR
Person-Centred Masterplan
Learning from the rainforest
• Accessible yet protected middle layer
• Between ED / logistics and ward towers
• Green fingers offer daylight and ventilation

UNDERSTORY
Person-Centred Masterplan

Learning from the rainforest


• Most ventilated and day-lit layer
• Quiet and secured ward towers
• Inter-connected by link bridges

CANOPY
Person-Centred Masterplan

Learning from the rainforest


• Rooftop farming and gardens
• Healing landscapes

EMERGENT
Person-Centred Masterplan

Learning from the rainforest


• Nature for both public and patients
• Topography creates different zones
• Continuity of landscape across both sites
Person-Centred Masterplan

Thermal comfort affects the


working conditions of the health
care personnel and the overall
satisfaction of the patients

• North-south orientation
• Minimises direct solar heat
• Maximises cross ventilation
• Pivot windows for NV or AC
Person-Centred Masterplan

Good wayfinding
design promotes
SOC
healing because
being able
to understand their AH / CH
environment
provides visitors with
LTC
a sense of control
and empowerment

Masterplanning for Wayfinding


• Central spine concept
• Effective sightlines
• Distinctive Characters
Person-Centred Masterplan

Distinctive Characters
• Consistent architectural language
• Colour identities
• Integrated park ensures visibility
Person-Centred Masterplan

Distinctive Characters
• Consistent architectural language
• Colour identities
• Integrated park ensures visibility
Person-Centred Masterplan

Distinctive Characters
• Consistent architectural language
• Colour identities
• Integrated park ensures visibility
Person-Centred Masterplan

Good acoustics provides


a “healing environment”,
high levels of speech
intelligibility to support
communications and
reduce medical errors

Acoustic Wind Catcher


• Significant reduction of noise
• Enhances wind speed
• Maintain visibility and daylight
• ‘Memory Lane’ in Atrium
Person-centred Masterplan
The Nature of Healing
• Healing Forest
• Healing Gardens
• Active Living Design

Communal Effect
The Nature of Healing
The Nature of Healing

Zonal Approach for


Healing Landscapes
The Nature of Healing

Zone 1 – Dementia Garden


Outdoor walks provide multiple emotional
and physical benefits for dementia patients,
such as stress reduction, improving sleep,
digestion and flexibility

Zone 1 Healing Landscape


• Dementia Garden
• Single loop concept
• Contained space
• Quiet & introspective
The Nature of Healing

Rehab gardens have


measurable benefits for
patients who have had
medical conditions such
as stroke, or brain injury

Zone 2 Healing Landscape


• Rehab Garden
• Private inpatient zone
Zone 2 – Rehab Garden • Designs for restoring ADLs
• Shades and lush landscape
The Nature of Healing

Intergenerational activities,
including volunteering and
reminiscence components,
have been associated with
an overall positive trend in
physical health outcomes

Zone 3 – Intergeneration Garden Zone 3 Healing Landscape


• Intergenerational Garden
• Common secured zone
• Interactive activities
suitable for both groups
The Nature of Healing

Whereas people might not


maintain enthusiasm for a
dedicated exercise program,
incidental physical activity
requires less motivation

Zone 4 – The Terraces


Zone 4 Healing Landscape
• Landscaped terraces
• Seating integrated
• Stage for performance
• Water feature
The Nature of Healing

Enhancing Patient Outcome


through Views of Greenery
The Nature of Healing

In all types of healthcare


settings, patient satisfaction
Enhancing Patient Outcome is strongly associated with
through Views of Greenery their waiting experience
The Nature of Healing

Enhancing Patient Outcome


through Views of Greenery
The Nature of Healing

Ample greenery in outdoor space


at residential facilities for older
people appears to promote
Enhancing Patient Outcome experiences of being away and
fascination, more frequent
through Views of Greenery visitation and better health
The Nature of Healing

Enhancing Patient Outcome


through Views of Greenery

Patients with views to


nature benefit from shorter
hospital stays and better
emotional wellbeing
The Nature of Healing
Stair climbing helps
protect against high
blood pressure, weight
gain and clogged
arteries. This lowers
the risk of diabetes,
heart disease, and
even some cancers

Encouraging
Active Living
• Campus design
conducive for
physical activity
• Exercise / Cycling /
Walking / Use of
staircases
• Rooftop farming
• Overall wellbeing
of the individual
The Nature of Healing
Person-centred Masterplan
The Nature of Healing
Communal Effect
• Places for Family and Friends
• Home-like Nursing Home
Communal Effect

2 The Hangout 1 North Foyer

4 Healing Forest 3 Terraces 8 Verandahs


7 The
5 Healing Plaza
Forest
6 Wood Land Garden 9 South Foyer

1 AH / CH Touchpoint Mapping
SOC
2 Green
4 Fingers

7 8 AH / CH
5
4
Green
3 Fingers

8 AH / CH
LTC
Green
6 9 Fingers

AH / CH
Communal Effect
Places for Family and Friends
By increasing the attractiveness
of the waiting area with plants,
hospitals can create a pleasant
atmosphere that positively
influences patients' well-being
Communal Effect

Positive and enjoyable


recreation experiences
can decrease stress and
psychological tensions
Communal Effect

Studies have shown


benefits of communities
and reminiscence therapy
on dementia patients

Memory Lane
Communal Effect

Memory Lane
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